Antibiotic resistant gonorrhea found in King County

Antibiotic resistance is a growing concern in the healthcare community. Antibiotic resistance is said to have occurred when an antibiotic loses its ability to effectively kill bacteria. The bacteria are “resistant” meaning that they continue to multiply, and the infected person is not cured. Public Health – Seattle & King County’s STD Clinic Director, Dr. Lindley Barbee, MD, MPH has found antibiotic resistance in a drug that is used to treat gonorrhea. We talked to her to find out more.

Dr. Barbee, what did your study show?

Azithromycin is one of two front-line antibiotics used to treat gonorrhea. We found that among men who have sex with men attending the STD clinic in Seattle, about 5% have a type of gonorrhea that can no longer be treated by azithromycin. Our study calls into question whether this drug should be part of standard gonorrhea treatment.

Dr. Lindley Barbee, MD, MPH

Why are you worried about your azithromycin findings?

Based on our findings, we may have to stop using azithromycin as a treatment for gonorrhea. That means there will be one less treatment for a disease that is on the rise – gonorrhea was up 15% across King County in 2016.

Were patients who received azithromycin not cured of their gonorrhea?

Our treatment protocol calls for the use of two drugs – azithromycin and ceftriaxone are used simultaneously. Our study did not find any “treatment failures” among men treated with both ceftriaxone and azithromycin, meaning that the second drug, ceftriaxone, still worked to cure the patients of their illness.

Is antibiotic resistant gonorrhea a particular concern?

Yes, because gonorrhea is a very tricky bacteria to treat. In fact, CDC has identified gonorrhea as one of the top three diseases at risk for becoming antibiotic resistant. Gonorrhea has already become resistant to penicillin and tetracycline – this happened back in the 1970s. Fluoroquinolones (like Ciprofloxacin) were a second line of defense, but gonorrhea became resistant to them as well. At this point, we’re left with ceftriaxone as our last line of defense.

What do your findings mean for the long-term treatment of gonorrhea?

If there are fewer drugs to treat gonorrhea, we need to be even more focused on disease prevention as a first line strategy. In the case of gonorrhea, this means people need to know what’s putting them at risk for getting gonorrhea, and taking steps to avoid those behaviors. For example, people who have sex with multiple partners, or partners whose health status is unknown to them, need to be using condoms every time they have sex.

If you’re a person who is at higher risk (such as a man who has sex with men with more than one partner), talk to your doctor or other clinician about how often you should get tested. We recommend that people in higher risk groups get tested every 3 months. It’s also important to get tested at all potentially exposed sites – that means not just urine testing, but also collecting specimens from the throat and rectum if individuals perform oral sex or receptive anal intercourse.

Why would getting tested every 3 months help stop gonorrhea?

The quicker we identify a case of gonorrhea, the quicker we can cure the infected person – and his/her partners – of this disease. A person with gonorrhea frequently doesn’t have any symptoms, so the only way to rule it out is to get tested. People can get tested at their regular doctor’s office, or they can come to the STD clinic. We provide non-judgmental and confidential testing and treatment on a sliding scale.